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The following is a summary of “Association between different proportions of crescents and the progression of IgA nephropathy (IgAN): a systematic review and meta-analysis,” published in the November 2024 issue of Nephrology by Yu et al.
Immunoglobulin A nephropathy (IgAN) has variable clinical outcomes. Reliable prognostic markers are essential for effective risk stratification and treatment.
Researchers conducted a retrospective study to analyze the influence of crescent proportions on the progression of IgAN.
They searched 4 databases (PubMed, Web of Science, Embase, and Cochrane Library) focusing on patients with IgAN and kidney outcomes, including end-stage kidney disease (ESKD). They calculated hazard ratios (HR) for binary outcomes.
The results showed that the meta-analysis included 13 studies with 11,849 patients. The crescent formation was linked to an increased risk of kidney outcomes (HR = 2.01, 95% CI 1.40–2.87, P < 0.001). A crescent proportion >10% (HR = 1.8, 95% CI 1.32–2.45, P < 0.001) and >25% (HR = 2.11, 95% CI 1.47–3.02, P < 0.001) significantly raised the risk of kidney outcomes. For ESKD, a proportion >25% indicated an elevated risk (HR = 1.70, 95% CI 1.18–2.44, P = 0.004), while a proportion >10% did not (HR = 1.12, 95% CI 0.36–3.47, P = 0.842).
The study concluded that crescent proportions were strongly linked to IgAN progression, with levels exceeding 25% serving as reliable prognostic markers for adverse kidney outcomes and ESKD.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03839-w
